Seven companies – Bramble Hub, Deloitte, EY, KPMG, McKinsey & Co, Newton Europe and PwC – are being paid up to £42m for an initial two-month data contract, amid growing concern over the increasing role played by management consultancies within the health service.

Forming part of health secretary Sajid Javid’s ‘delivery plan’ to clear the surgery waiting list backlog – currently around six million patients – the contract is designed to provide “system planning” to support the elective recovery programme. 

It will see up to £500,000 being spent across each NHS England region (presumably each integrated care system) up until 31 March, with an option to extend the project by six months and allocate a further £500k per ICS. 

News of the contract emerged earlier this month and coincided with a move by NHS Shared Business Services – a joint venture set up by the Department of Health & Social Care and French outsourcing specialist Sopra Steria – to tender for a new contract worth £500m to create a framework for the provision of IT consultancy, advisory and delivery services to the NHS

It’s unclear whether either development is related to the apparent merger of NHS Digital and NHSX within NHSE’s recently established ‘transformation directorate’, but they reflect a continuing willingness to embed consultancies within the health service, despite the private sectors record of poor performance.

Four years ago the independent newsletter The Conversation analysed how more than 100 NHSE hospital trusts – each spending an average of £1.2m a year on consultants – became almost 10 per cent less efficient, and lost around £11,000 for every £100,000 spent. 

Last February it followed this up with research showing demand for consultancy advice within NHSE was growing despite evidence that using external advisers actually generated inefficiencies. The Conversation also noted that hospital trusts were rarely hiring consultants to make up for a shortage of in-house managers – in fact the biggest users were those trusts employing relatively more managers.

The Lowdown also offered its own exhaustive analysis of the sector 12 months ago, when it noted that consultancy firms have played a key – and lucrative – role in most of the big re-organisations of the NHS going back at least to 1974. Tellingly, it highlighted a warning from the Financial Times in 2017 which suggested an analogy between consultants and vermin: “The … danger is that consultants become a habit – once they get inside the building, they are hard to eradicate.”

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